Gastrointestinal (GI) malignancies remain a central focus of research and treatment within the oncology community. Colorectal cancer remains the third most common cancer diagnosed in the United States, as well as the second leading cause of cancer death.1 Research conducted by the Centers for Disease Control and Prevention found that nearly one in three adults aged between 50 years and 75 years—the prime recommended ages for colon cancer screening—fail to receive a recommended colonoscopy.2 And recent research published by the American Cancer Society showed a surprising increase in colon cancer diagnoses among individuals aged younger than 55 years, which some have suggested should lead to a reconsideration of the age at which colonoscopy screening should commence.3
While curative treatment options for patients with colorectal cancers have continued to improve over the years, researchers have noted stagnation in other areas of GI cancer. The 5-year survival rate for patients with pancreatic cancer ranges from 14% for patients with stage I disease to 1% for patients with stage IV tumors.4 Patients with esophageal cancer have a 5-year survival rate of approximately 20%.5 Despite extensive research in both of these areas, many oncologists feel that the ideal treatment regimens for these cancers have not yet been identified.
ASCO’s 2017 GI Cancers Symposium focused extensively on new treatments for malignancies across the GI spectrum. The conference also highlighted research in the areas of value-based care for patients with GI cancers, with special focus on the rising costs of cancer care for patients with colorectal, pancreatic, and esophageal tumors. Research presented at the Symposium also focused on the safety, efficacy, and cost-effectiveness of surveillance following curative treatment; the potential effect of introducing colon cancer screening into a younger patient cohort; and the efficacy and cost of chemotherapy in patients with advanced gastric cancers.
The cost of colon cancer care rose significantly during the period from 2003 to 2013, despite decreases in overall hospitalizations and lengths of stay.
Costs associated with maintenance bevacizumab (Avastin, Genentech/Roche) and capecitabine for patients with metastatic colorectal cancer exceeded willingness-to-pay thresholds and were not deemed cost-effective, according to an analysis of randomized trial data.
A pilot program for Direct Access Colonoscopy Screening (DACS) increased overall screening rates for colorectal cancer by nearly 100% in a selected cohort, according to study results.
A novel scoring system may identify elderly patients with advanced gastric cancer who may not benefit from chemotherapy.
1. Key statistics for colorectal cancer. American Cancer Society website. https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html. Accessed March 3, 2017.
2. Colorectal cancer screenings remain low. Centers for Disease Control and Prevention website. https://www.cdc.gov/media/releases/2013/p1105-colorectal-cancer-screening.html. Published November 5, 2013. Accessed March 3, 2017.
3. Siegel RL, Fedewa SA, Anderson WF, et al. Colorectal cancer incidence patterns in the United States, 1974-2013 [published online February 28, 2017]. JCNI:
J Natl Cancer Inst. doi:10.1093/jnci/djw322
4. Pancreatic cancer overview. Mayo Clinic website. http://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/home/ovc-20268502. Accessed March 3, 2017.
5. Esophagus cancer. American Cancer Society website. https://www.cancer.org/cancer/esophagus-cancer.html. Accessed March 3, 2017.